Ask a PT

156 Posts
 
Posted - 10/12/2007 :  13:19:33  Show Profile  Reply with Quote
Our user asked: "About ten months ago the knuckle of the index finger of my left hand became extremely swollen without any apparent cause. The finger was distended to the point of stretching the skin around the joint. It was very painful. My general practitioner sent me to an arthritis spe****t. between the two of them they took x-rays of the joint and a battery of blood tests. Neither of them found anything that specifically pin pointed the cause. At the end of that round of treatment I was told to take an Naproxin Sodium in the morning and evening. After 4-5 months of this regimen I was still experiencing the same symptoms to a somewhat lesser degree. I stopped taking the Naproxin Sodium and began to exercise on my bicycle for an hour two or three days a week. I have seen a dramatic decrease in swelling and much less discomfort. The joint is slightly larger than it's counterpart on my right hand, but that is much better than it had been. My major problem now is the inflexibility and weakness of the joint in question. I can only flex the joint about 35-45 degrees compared to the 100 degrees that I can flex the same joint on my other hand. I revisited my primary care physician who sent me to a orthopedic specialist this time. The orthopedic specialist told me that I needed about six weeks of two visits a week for physical therapy. He mentioned finger wrapping exercises, but not much else. He also indicated some pessimism about my regaining full function in my finger. He didn't have any explanation of what might have been the original cause. I would like to know if there are exercises that I could use on my own to restore strength and flexibility the knuckle of the index finger on my left hand. Any help will be appreciated."

Ask a PT Response: "From what you have described, your best option to achieve maximal results would be to consult with a certified hand therapist or occupational therapist. I would say most physical therapists do not have as much training with the hand as compared to an occupational therapist or certified hand therapist. If the physical therapist that you are seeing has this experience, than that should be fine. Studies have shown that exercise does help with managing pain and edema for some patients as it helps improve circulation and releases opiates. That maybe why your condition has improved somewhat. Your limited range of motion at your fingers could still be partly due to the edema you continue to experience. You can expect the OT or certified hand therapist to perform or have you perform activities such as: range of motion exercises, strengthening exercises, joint mobs, manual therapy and modalities (ie. parrafin wax, fluidotherapy, etc..). Good luck with your finger and thanks for using CyberPT."